IBD- Ulcerative colitis

What is Ulcerative colitis?

Ulcerative colitis (UC) is a life long chronic inflammatory bowel disease (IBD) that affects the large intestine, specifically the colon. It is an immune-mediated inflammatory condition associated with inflammation of the rectum but can involve, and often does involve other areas of the colon.

UC can cause debilitating physical symptoms such as an inflamed rectum, urgency and a sense of pressure, urgent diarrhoea, vomiting, anorexia (no appetite), fatigue, and rectal bleeding (Cleynen et al., 2016).

These symptoms come and go, or relapse and remit, going between an active phase and an inactive phase – to note that in some clients, the active phase may go for longer than you would expect (Cleynen et al., 2016; Rubin et al., 2019).

When in an active phase, UC is associated with anxiety, depression, impaired social interaction, impaired career progression (Rubin et al., 2019). The link between inflammation, altered microbiome, and phycological distress, anxiety, and depression has been shown (Humbel et al., 2019).

Long term UC is associated with an increased risk of dysplasia (changes to the cells) and colorectal cancer due to chronic inflammation (Rubin et al., 2019). – Want to know the difference between acute and chronic inflammation? Click HERE!

As of today, there is no “cure” for IBD, but many treatment options are available to manage the disease.

Who gets ulcerative colitis?

UC predominately peaks between ages 15-30 years but can present at any time and at any age (Rubin et al., 2019).

Research shows that 1 in 200 have some form of IBD, whether its Crohn’s disease or UC, and that this number is increasing. Both Crohn’s and UC have a genetic factor that comes into play (Cleynen et al., 2016). This does not mean that if you have the gene, that you will get the disease, rather that you have what I would call a predisposition to risk factors for the disease. So in a way, in the future, knowing if you have the gene, may allow you to modify your lifestyle factors and decrease your chance of inheriting the disease.

Risk factors include:

• A family member has/had ulcerative colitis or Crohn’s disease; the greatest risk is with first-degree relatives, however, is also present in second and third-degree relative.
• Use of non-selective non-steroidal anti-inflammatory drugs (NSAIDS): these may worsen the disease.
• Being an ex-smoker.

Treatment options for ulcerative colitis

The best treatment is a diagnosis! UC is treated medically through steroids, and the goal of medical treatment is a prolonged period of steroid-free remission, and a return to a normal health-related quality of life, prevention of morbidity (e.g. hospitalisation), and prevention of cancer (Rubin et al., 2019).

The goal of treatment is to support the mucosal layer of your epithelial tissue to heal (Rubin et al., 2019) – more about gastrointestinal cells, and their roles can be found here.

There are several naturopathic treatment options for ulcerative colitis including:

Stress management techniques

• Meditation
• Breathing exercises
• Self-reflection
• Modification of lifestyle triggers

Increasing omega 3’s in the diet

• Consumption of fish 3 times a week
• Handful of nuts and seeds each day – if tolerable.

Use of specific dietary interventions

• Specific Carbohydrate Diet: a recent study showed that clients perceived that the SCD improved their symptoms and helped support the remission of the disease (Suskind et al., 2016).
• Mediterranean diet: supports increased omega 3 intakes, may help decrease inflammation.
• Targeted probiotics
• An exciting new area of research is faecal microbiota transplantation, which involves taking healthy microbiota, “cleaning” it and formulating a pill, which is then given to the client over a period of time. This works to promote a healthy microbiome, which is associated with healing of the muscoal layer, and a decrease in “bad” bacteria – which is implicated in the pathogenesis of UC (Paramsothy et al., 2017). This new area of research has shown to be safe and tolerable in long term studies (Ding et al., 2019).

A comprehensive naturopathic check-up will also include looking at your individual symptoms and using herbs, nutrition, and lifestyle modifications to reduce symptoms severity.

If you are wanting help managing your condition, click here to book in for a 1:1 consultation with me.

Medical Disclaimer. The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. All content, including text, graphics, images, and information, contained on or available through this web site is for general information purposes only.

References

Cleynen, I., Boucher, G., Jostins, L., Schumm, L. P., Zeissig, S., Ahmad, T., Andersen, V., Andrews, J. M., Annese, V., Brand, S., Brant, S. R., Cho, J. H., Daly, M. J., Dubinsky, M., Duerr, R. H., Ferguson, L. R., Franke, A., Gearry, R. B., Goyette, P., … Lees, C. W. (2016). Inherited determinants of Crohn’s disease and ulcerative colitis phenotypes: A genetic association study. The Lancet, 387(10014), 156–167. https://doi.org/10.1016/S0140-6736(15)00465-1

Ding, X., Li, Q., Li, P., Zhang, T., Cui, B., Ji, G., Lu, X., & Zhang, F. (2019). Long-Term Safety and Efficacy of Fecal Microbiota Transplant in Active Ulcerative Colitis. Drug Safety, 42(7), 869–880. https://doi.org/10.1007/s40264-019-00809-2

Humbel, F. ., Juillerat, P. ., Scharl, M. M. ., Misselwitz, B. ., Schreiner, P. ., Macpherson, A. J. ., Rogler, G. ., von Känel, R. ., Yilmaz, B. ., & Biedermann, L. (2019). Gut-Brain-Axis Revisited: Shedding Light on the Mucosa Associated Microbial Composition in Ibd Patients with Psychological Distress, Anxiety and Depression. Gastroenterology , 156(6), 433. https://doi.org/10.1016/S0016-5085(19)37930-2

Paramsothy, S., Kamm, M. A., Kaakoush, N. O., Walsh, A. J., Van Den Bogaerde, J., Samuel, D., Leong, R. W. L., Connor, S., Ng, W., Paramsothy, R., Xuan, W., Lin, E., Mitchell, H. M., & Borody, T. J. (2017). Multidonor intensive faecal microbiota transplantation for active ulcerative colitis: a randomised placebo-controlled trial. The Lancet, 389. https://doi.org/10.1016/S0140-6736(17)30182-4

Rubin, D. T., Ananthakrishnan, A. N., Siegel, C. A., Sauer, B. G., & Long, M. D. (2019). ACG Clinical Guideline. The American Journal of Gastroenterology, 114(3), 384–413. https://doi.org/10.14309/ajg.0000000000000152

Suskind, D. L., Wahbeh, G., Cohen, S. A., Christopher, Damman, J., Klein, J., Kim Braly, Shaffer, M., & Lee, D. (2016). Patients Perceive Clinical Benefit with the Specific Carbohydrate Diet for Inflammatory Bowel Disease. Digestive Diseases and Sciences, 61, 3255–3260. https://doi.org/10.1007/s10620-016-4307-y